Exercise Transcutaneous Oximetry of the Buttocks - External Validation With Computed Tomography Angiography

Abstract

Background: Exercise transcutaneous oximetry (Ex-tcPO2) is a non-invasive test for exercise-induced buttock ischemia. Prior study defined Ex-tcPO2 normal/abnormal cut-offs against arteriography but no external validation was available. The aims of this study were therefore to (1) determine the diagnostic performance of Ex-tcPO2 against CTA; (2) determine the cut-off point for detection of stenosis >75% in arteries toward the hypogastric circulation; and (3) determine the effect of chest profile classification on the diagnostic performance of Ex-tcPO2.Methods and Results:A total of 207 patients referred for Ex-tcPO2 were analyzed. DROP during Ex-tcPO2 was compared with the CTA results. Chest-tcPO2 changes were automatically classified into pre-defined profiles representing normal or abnormal responses. Using DROP <-15 mmHg as a cut-off, Ex-tcPO2 had 80.2% sensitivity, 72.3% specificity, 43.1% PPV, 93.3% NPV and 73.9% accuracy, to detect 1 stenosis >75% in arteries toward the hypogastric circulation. Optimal DROP to detect stenosis was: -15 mmHg. The overall diagnostic performance of Ex-tcPO2 was independent of chest profile classification.

Conclusions: Ex-tcPO2 has satisfactory diagnostic performance to detect arterial stenoses towards the hypogastric circulation. Abnormal chest-tcPO2 profile does not impair the overall diagnostic performance of the test.

Keywords: Claudication; Computed tomography; Peripheral artery disease.